From Flu Wiki 2

Forum: New Egyptian Cases

JWB?23 December 2006, 20:25

http://www.breitbart.com/news/2006/12/23/061223194046.mcmjylzx.html

Two New Egyptian cases.

recombinomics Commentary

http://www.recombinomics.com/whats_new.html

JWB?23 December 2006, 20:31

….Clustering in the same Gharbiya govenorate as the earlier case is cause for concern. The current cluster as well as the initial case had linkages to ducks and the H5N1 from the first case had M230I. This polymorphism is found in all three strains of human flu (H3N2, H1N1, and influenza B), all of which are efficiently transmitted human-to-human. The earlier H5N1 is an exact match with positions 226–230 influenza B (QSGRI). The first indication of efficient transmission is a familial cluster, as described in the translation above.….

http://tinyurl.com/ydlcmv

More details on condition of the sister and any relationship with the other two hospitalized patients would be useful (as would tesing and sequencing updates).

RBD?24 December 2006, 10:02

More suspect cases

http://www.recombinomics.com/News/12240603/H5N1_Egypt_Gharbiya_More.html

Kelly from MI?24 December 2006, 10:13

Eighth Egyptian dies

http://tinyurl.com/yxyzc4

KellyP ?24 December 2006, 11:42

Okay, so can we panic now? The woman is part of a family cluster. If she got the flu from chickens, it’s just another bird flu fatality. If she got it from one of her family members, it’s NOT just another bird flu fatality.

Daggumit! I don’t have enough supplies!

KellyP from CA?24 December 2006, 11:44

Too many Kellys in this forum. I should rename myself. ;)

huddy?24 December 2006, 11:53

“Okay, so can we panic now?” what exactly do you think is going to happen here?

KellyP from CA?24 December 2006, 11:55

I dunno…maybe the virus got better at human2human transmission?

quilter1?24 December 2006, 12:25

Note she did not get it from chickens. She got it from ducks. Right. What a way to start Christmas Eve. My PPF is quivering, wanting to jump up. Down, down, I say. It’s Christmas. Move along, It’s Christmas. Nothing more till new years. At least they test and post results faster there.

Ruth?24 December 2006, 12:46

Actually it took them about 9 days to test. A long time to infect alot of people along the way. My question would be: Is it becoming easier to go b2h or h2h? Time will tell. We should hear about new cases very shortly if it’s h2h. A few more in the same area over the next week, and I may start on my final prep list.

daddy24 December 2006, 15:06

with haji going on around that part of the world as well i hope the people that return dont bring anything nasty back with them

NawtyBits?24 December 2006, 23:19

quilter> ‘Note she did not get it from chickens. She got it from ducks.’

From the articles I’ve read, they have been very careful to say the siblings got it from slaughtering ducks. Then they only say that the cousin got infected also. The cousin doesn’t appear to have been involved in the culling, and appears to have denied contact with dying/dead birds. So, it would be reasonable for one to assume that the dead cousin did NOT get it from birds, or the WHO would have come out and said specifically that the cousin had contact wioth the dead birds also. That;s the way I read it, anyway.

quilter1?25 December 2006, 01:03

Nawty, you’re right. I can hope tho. It would be so much easier if we could say “birds”, not h2h.

JWB?25 December 2006, 09:03

From Nimans site: http://tinyurl.com/ydet65

H5N1 Fatality in Gharbiya in Nile Delta Recombinomics Commentary December 24, 2006

When officials realised the woman was part of the same family, they tested her for bird flu and confirmed that she was infected with H5N1, and she was moved to a Cairo hospital, but died shortly thereafter.

The two siblings are in hospital in Cairo and have been treated. The rest of the family is under close medical surveillance, Bushra said.

The above comments confirm the second fatality this season in the Gharbiya province in the Nile Delta. The first case died October 30 and lived about 15 miles north of the current cluster of three confirmed cases. Two of the four confirmed cases this season have been fatal, and the geographical and familial clustering are cause for concern.

Moreover, the failure to test the hospitalized patients because of a lack of a bird link is an additional cause for concern. The four confirmed cases, as well as additional suspect cases, are in the Nile Delta under the flight path of migratory birds birds infected with the H5N1 Qinghai strain. These birds excrete feces with H5N1, so direct contact with birds should not be a testing requirement.

The disease onset dates of the siblings of the index case also suggest human-to-human transmission may have also become more efficient. The H5N1 from the earlier case had M230I, which is found in the efficiently transmitted human H1N1, H3N2, and influenza B strains.

The clustered fatal infections in the migratory path across the Nile Delta remain causes for concern.

JWB?25 December 2006, 09:58

Let’s hope the egyptians don’t start dumping dead chickens into the Nile river again.


From February, 2006…. http://tinyurl.com/hr2zx

Spooked by Bird Flu, Egyptians Hoard Water Residents of Cairo Fear Chickens Dumped in the Nile Could Infect Their Drinking Supply

By Daniel Williams Washington Post Foreign Service Sunday, February 26, 2006; Page A12

CAIRO, Feb. 25 — Of all the panicky ways that people worldwide have sought protection from bird flu, perhaps the most striking took root among Egyptians last week. Via e-mail and through advice dispensed on crowded city streets, word went out: Don’t drink the water.

Farmers, including the rooftop poultry breeders that are a Cairo fixture, had begun to dump stricken, dead chickens into the Nile River, the source of drinking water for millions of Egyptians, newspapers and satellite television reported. Taps were suddenly turned off and people rushed to stores to buy bottled water…….

quilter1?25 December 2006, 12:57

CAIRO (AFP) - A 15-year-old girl has died from the H5N1 strain of bird flu, the second such death in as many days in Egypt, the health ministry in Cairo said.

Her death brought to nine the number of people who have died in Egypt after contracting the deadly strain — the previous victim being a 30-year-old woman from a village in the central Nile delta region who died on Sunday.

This all over newsnow, yahoo, etc.

NS125 December 2006, 23:40

Bear in mind that no M230I is yet confirmed in the recent cluster because no sequences have been discussed. Only one case, Egypt 12374, an October fatality, has been confirmed with M230I.

On the other hand, I’m quite in agreement with a lead investigator that the regional polymorphism has a significant opportunity for conservation in Egypt for this season if it does, in fact, appear in the recent cluster.

Also recall that P239S also was found in the Egypt 12374 strain and that S227N was predicted in the region by Niman and then noted in the Egypt 2947strain.

Mary in Hawaii?26 December 2006, 20:22

4 to 7 new suspect cases now reported in Egypt. Here’s the link to the fluwikie thread.

http://www.newfluwiki2.com/showDiary.do?diaryId=576#11868

JWB?26 December 2006, 20:58
 http://tinyurl.com/yxspvf

Commentary

Additional H5N1 Suspect Cases in Northern Egypt Recombinomics Commentary December 26, 2006

Pathological cases suspected of being infected with a new avian influenza in Beni Suef and Western [Al Gharbiyah]. Doctors at the hospital were surprised pathogenesis of Beni Suef appearance of the symptoms of the disease known Hoda Abdel-Hamid of the village of Blvia Amal Mohammad Omar from the village of Riyadh Pasha was accorded some medicines and drugs.

This brings the number of suspected cases of avian influenza in the bee Bank to 7 cases including 4 in the pathogenesis of hospital Mahala and 3 Hospital pathogenesis of Tanta.

The above translation describes four new suspect bird flu cases in two Egyptian governates, increase the total to seven. These cases are in addition to the four confirmed cases in Egypt this season. All four were withing 15 miles of Tanta, the capital of Gharbiyah, which is were three of the seven suspect cases are hospitalized.

These additional hospitalizations increase concerns. Three of the first four confirmed patients have died and the sequence of HA from the first case had acquired a number of polymorphisms found in other Qinghai isolates in the area. In addition, the first sequence has M230I, which is found in all three human influenza strains, H1N1, H3N2, and influenza B.

Additional information on these new suspect cases would be useful.

Mary in Hawaii?26 December 2006, 23:53

Here’s a little more data on the outbreak in gharbiyah involving the 2 recent deaths. What is interesting and new is that it reports 20 suspect cases in the area. (article link just appeared on News Now)

“Local news media reports suggest that there have been about 20 suspected human cases in the northern part of Egypt.

At least three were among 33 members of an extended family that lived in a compound in Hanut in Gharbiya Province. The woman, who died last weekend; her brother; and a niece were said to have fallen ill after slaughtering ducks for a cousin’s wedding.

Local reports said the authorities had declared an emergency and were trying to kill all the birds for a quarter-mile around the compound, but were frustrated by residents who hid birds under beds. Slaughtered birds were buried at a cemetery, streets were cleaned, and all 33 family members were tested.”

Ruth?26 December 2006, 23:55

http://tinyurl.com/yj2vlq 2 More Die as Bird Flu Continues Spreading to Humans in Egypt Local news media reports suggest that there have been about 20 suspected human cases in the northern part of Egypt.

LL?27 December 2006, 02:07

Doesn’t look good…

…”The event that will produce a pandemic will occur when the virus mutates into a form that humans can spread from person to person”…

…”The ``jump’‘ may have happened already”…

..”If you were going to design a virus for mutation, H5N1 would be it”… Locke said.

http://www.peninsuladailynews.com/sited/story/html/265674

LL?27 December 2006, 02:11

Doesn’t look good (II)

link

…”It’s not just complacency that worries Kasai. The virus is changing”…

Hope for the best!!!

daddy27 December 2006, 08:49

Avian flu reportedly jumped from birds to humans in Egypt

Several cases of avian flu have spread from poultry to humans in the Nile Delta, the Egyptian health authorities said this week as they worked to wipe out the outbreak among chickens and ducks.

A 15-year-old girl died Monday, a day after the death of a woman in her 30s whose family members showed symptoms of infection.

Egypt has reported nine confirmed human deaths from H5N1 avian flu since it was first found in birds in February and in a person in March.

At that time, the health and veterinary authorities canceled duck-hunting season, banned imports of live birds and forbade city dwellers to raise birds at home.

Officials also began culling diseased flocks and vaccinating healthy ones. They ran into early problems like vaccine shortages and widespread disregard for the new regulations by poor rural people who could ill afford to lose birds raised for food and sale.

Today in Africa & Middle East Israel approves new West Bank settlement Iraqi appeals court upholds death penalty for Saddam Islamists in Somalia are forced to retreat An Egyptian newspaper, The Daily Star, reported that 30 million birds had been slaughtered since then, mostly from the poultry industry, which suffered major losses.

Reports of the disease tapered off over the summer, but reappeared in September in the delta, an important stopover for migrating birds, with many moving through in December. Even in warmer climates, the disease peaks in cooler months.

The Egyptian Health Ministry offered sketchy details on the deaths. It sometimes takes the World Health Organization several days to confirm cases.

Local news media reports suggest that there have been about 20 suspected human cases in the northern part of Egypt.

At least three were among 33 members of an extended family that lived in a compound in Hanut in Gharbiya Province. The woman who died last weekend, her brother and a niece were said to have fallen ill after slaughtering ducks for a cousin’s wedding.

Local reports said the authorities had declared an emergency and were trying to kill all the birds for 400 meters, or about a quarter-mile, around the compound, but were frustrated by residents who had hidden birds under beds.

Slaughtered birds were buried at a cemetery, streets were cleaned, and all 33 family members were tested.

As of the latest WHO update on Nov. 29, avian flu had infected 258 people worldwide, killing 154 of them. Indonesia had the most deaths, followed by Vietnam and Thailand. But Indonesia, Egypt and possibly China appear to have the most active outbreaks at the moment.

please ecuse my ignorance but are they trying to say it was h2h between these people.

NS127 December 2006, 09:01

Egyptian man dies of bird flu, 10th death

CAIRO, Dec 27 (Reuters) - A 26-year-old Egyptian man died of bird flu on Wednesday after 10 days in hospital, an official of the World Health Organisation (WHO) told Reuters.

Brick factory worker Rida Farid Abdel Halim was the [b]third member of an extended family[/b] in the Nile Delta province of Gharbia to die of the disease, said Hassan el-Bushra, WHO regional adviser for communicable diseases surveillance.

Now we’re in double digits in Egypt deaths.

NS127 December 2006, 09:02

Seems that we’d be seeing more confirmations of family members of the first three people from the large household if M230I were present? Tests apparently have been done on all 33 members of the household?

If we see the NS1 gene segment change along with the M230I or the S227N, we may be looking at a larger outbreak soon. I’m not sure that the Egyptians are taking this seriously?

We really can’t know until they release the tests and the sequences, but a 100% CFR this season is looking very Highly Pathogenic.

Sidescroll Alert?27 December 2006, 10:58

Sidescroll Alert

cassandra27 December 2006, 12:10

Daddy - is your post a quote from a news story? I was just wondering where it came from, or if you wrote it.

daddy27 December 2006, 12:17

sorry casandra it was a news report off the news now website

daddy27 December 2006, 12:19

http://www.iht.com/articles/2006/12/27/news/egypt.php

heres the link sorry for not posting it sooner

Bump - Bronco Bill?27 December 2006, 14:10

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I’m-workin’-on-it31 December 2006, 00:00

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NS101 January 2007, 07:48

H5N1 Cluster in Gharbiya Egypt Cause Concern

Clinical specimens from the three cases were tested positive for avian influenza A(H5N1) virus by Egyptian Central Public Health Laboratory. The virus was also detected in specimens from two of the three patients by US Naval Medical Research Unit No.3 (NAMRU-3).

Apparently NAMRU-3 were able to isolate virus in at least 2 of the 3 new cases. Entries have been made at GenBank. Hopefully, we’ll see these released in a few days.

Looking at the recent filings from the region, I wonder what we’ll find in the new Egypt sequences?

Transmission was somewhat inefficient, 33 in a house and very few ill at the moment. NAMRU-3 may not release much on the virulence factors. We’ll probably be stuck again with the Hemagglutinin segment only. So let’s think about some possibilities.

While Dr. Niman is waiting patiently and commenting little, I’m not so patient today . . . perhaps it’s the year-end or something.

My thoughts today:

S227N (Turkey and 1 Egypt 2947) may have an equal or better possibility of emergence in these new cases as the M230I (Egypt 12374). I won’t be surprised to see both if all three recent strains are eventually released, but I don’t expect yet to see S227N and M230I in a single strain.

Looks like N186S/K activity (6 Iraqi and 2 Azer) is more likely than Q196R, though 192 to 196 has been busy around the world.

I have a distinct curiousity about the 158/159 area.

Possible combinations:


or --------------------

No predictions here, just wondering and thinking aloud, because we won’t have enough data for predictions even with 6 months of full release.

cottontop?01 January 2007, 08:00

If all three have the same symptoms,and had contact with infected chickens/ducks, and each other, how is it that only two tested postive for H5N1?

Bump - Bronco Bill?01 January 2007, 09:02

..

NS101 January 2007, 12:00

3 tested positive on antigen tests. NAMRU-3 was only able to isolate the virus from 2 of them so far. Not unusual according to when / where the specimen is taken.

Two completely different tests.

So you have three confirmed H5N1 cases and we’ll only have two sets of sequences.

JWB?05 January 2007, 19:46

Things are getting interesting, (and scary)……

A Dr. Niman induced thread at Monotreme’s site……

http://tinyurl.com/yyl4h8

KellyP from CA?06 January 2007, 01:01

JWB, Can you please elaborate what Monotreme’s site is saying please? I read it but gained little if any enlightenment. :)

NS106 January 2007, 01:27

The two isolates that were sequenced from the recent Egypt cases will be publicly available on Wednesday.

Niman will discuss those sequences then.

KellyP from CA?06 January 2007, 02:49

Ah…so there should be plenty of nail-biting until then.

RBD?06 January 2007, 09:20

There will be more nail biting after the sequences are released.

Wednesday, only the HA sequences will be available:

A/Egypt/14724-NAMRU3/2006 and A/Egypt/14725-NAMRU3/2006 will be available under accession numbers EF200512 and EF200513.

A sneak preview is now showing at

http://www.recombinomics.com/News/11070602/H5N1_RBD_Shantou.html

RBD?06 January 2007, 10:03

A second sneak preview is at

http://www.recombinomics.com/News/11070603/H5N1_RBD_China_Pandemic.html

H5N1 knows how the game is played.

NS106 January 2007, 12:31

We’re discussing the issue in-depth at

Not a Pandemic?06 January 2007, 13:12

Just remember, human to human does not a pandemic make.

While there may be human to human transmission in Egypt, I believe we have see that before (Turkey/ Indonesia).

The pandemic lies in EFFICIENT human to human transmission, or sustained chains of transmission H-2H-2H.

The latter scenario is when TSHTF and we’re not there yet.

Close, but not there yet.

RBD?06 January 2007, 16:28

The sequences that will be released Wednesday will say quite a bit about how close H5N1 is getting.

The fact that the cluster is the largest reported to date in Egypt is not a coincidence.

KellyP?06 January 2007, 18:54

Okay…so if Wednesday’s report shows that it IS quite efficient, but contained (because no new cases have been found), would this then make it TSHTF time, or do other ‘relatively efficient’ cases have t start popping up all over for us to go on high alert and pull the signal for TSHTF?

Bronco Bill08 January 2007, 21:47

There is a new Egypt cases diary on the new Forum, titled Egypt, January 8 to…..

The last diary can still be found on the new Forum here: New cases In Egypt III

NS110 January 2007, 13:11

No sequences yet released at this time:

Noon Central US.

NS110 January 2007, 15:51

Perhaps tonight.

Sometimes GenBank does their update cycle in the evening according to Niman.

DemFromCT10 January 2007, 16:05

NAMRU has a good track record on releasing sequences.

cottontop?11 January 2007, 09:15

These’s sequences were suppose to have been released yesterday. What gives? I can’t stand the waiting. (Hmmmm! ;-))

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